Summary: We will not investigate Mr X’s complaint about his father Mr Y’s Care Provider’s fee increases. There is not enough evidence of the Care Provider’s actions amounting to fault to warrant investigation. It would not be unreasonable for Mr X to go to court to get a strict interpretation of the care contract’s terms. Investigation would not achieve a different outcome nor achieve the complaint outcomes Mr X seeks.

The complaint

1. Mr X is Mr Y’s son. Mr Y is in a privately funded Bupa care home placement. Mr X complains the fees for his father’s care home have increased at a compounded rate of over 85 percent over the last six years.
2. Mr X says the increases have caused him worry when trying to plan for Mr Y’s long-term care. He wants the care provider to better explain the reasons for the increases being higher than other providers and the Consumer Prices Index, consider halting the latest rise, and commit to make no further fee increases.

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The Ombudsman’s role and powers

3. We investigate complaints about adult social care providers and decide whether their actions have caused an injustice, or could have caused injustice, to the person making the complaint. I have used the term fault to describe such actions. (Local Government Act 1974, sections 34B and 34C)
4. The law says we cannot normally investigate a complaint when someone could take the matter to court. However, we may decide to investigate if we consider it would be unreasonable to expect the person to go to court. (Local Government Act 1974, section 26(6)(c), as amended)
5. We provide a free service but must use public money carefully. We may decide not to start or continue with an investigation if:
• it is unlikely further investigation will lead to a different outcome; or
• we believe we cannot achieve the outcome someone wants.

(Local Government Act 1974, sections 34B(8) and (9))

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How I considered this complaint

6. I considered information from Mr X and the Ombudsman’s Assessment Code.

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My assessment

7. There is a contract in place for Mr Y’s placement. We can consider a contract using an ordinary reading and examine how it appears to any reasonable member of the public. But the strict interpretation of a contract is for the courts to do. We cannot say what is a fair cost for care or set how much a care provider can charge or by how much it may increase its fees.
8. The Care Quality Commission (CQC) regulates care providers in England. Regulation 19 of the CQC (Registration) Regulations 2009 is about fees. This requires providers to give people information about the terms and conditions of their care, treatment or support, including the expected costs and the requirement to pay for their care, treatment and support. Providers must notify people of any changes to their terms and conditions, including increases in fees, and give them enough time to consider whether they wish to continue with the service.
9. The Care Provider has given Mr X the terms and conditions of its care, explaining it will increase fees in January each year. The Care Provider aims to give at least 28 days’ notice before it increases the fee and will explain its reasons. It has considered it necessary to increase its fees above its standard 7 percent in 2025 and given its reasons. The Care Provider has reviewed its fees and written to Mr X with enough notice before it imposed the increase for Mr X to decide if he wants to continue with the service. It responded to Mr X’s complaint with further explanation for the increase. There is not enough evidence of fault by the Care Provider in how it has followed the terms and conditions to warrant investigation.
10. We recognise Mr X disagrees with the need to increase the fees by the amount set this year, and for the previous five years. Mr X accepted the previous years’ increases by retaining the Care Provider’s services over that period and paying the fees. The fees increase is not a dispute we can resolve. If Mr X is now no longer satisfied with the contract terms and fees, he is open to find an alternative provider, although we appreciate the impact moving could have on Mr Y. If Mr X wishes to challenge how the Care Provider has implemented the terms of the contract for Mr Y’s care, and the fee level, he would need to take legal advice. It would be reasonable for Mr X to pursue these issues at court because it is the body which can consider them.
11. We understand one of the outcomes Mr X wants from his complaint is for the Care Provider to give a better explanation of its fee increase. But the Care Provider has given its explanations in its response. While we realise Mr X is dissatisfied with them, investigation by us would not achieve a different outcome of further explanations, so we will not investigate.
12. We note Mr X also wants the Care Provider to consider stop the latest fee increase and commit to making no future fee increases. We cannot order care firms to alter their fees now or in the future. That we cannot achieve these outcomes for Mr X is a further reason why we will not investigate.

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Final decision

13. We will not investigate Mr X’s complaint because:
• there is not enough evidence of fault by the Care Provider to warrant us investigating; and
• it would not be unreasonable for Mr X to go to court for a strict interpretation of the care contract’s terms; and
• investigation would not achieve a different outcome; and
• we cannot achieve the complaint outcomes Mr X wants.

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Investigator's decision on behalf of the Ombudsman